Occupational asthma

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Last reviewed: 17 Aug 2025

Last updated: 15 Aug 2025

Occupational asthma (OA) should be suspected in all adult patients with asthma.

Occupational history may identify work-related causes. Details of work exposures should be obtained from material safety data sheets available to the patient from their workplace.

Objective evidence of asthma should be obtained from spirometry, a bronchodilator response, and/or a methacholine challenge. Tests should be performed when the patient is symptomatic and/or within days of exposure to a suspected etiologic agent.

In sensitizer-induced OA, removal from any further exposure to that agent is recommended if an immunologic response to the work sensitizer is demonstrated by skin or in vitro tests.

In irritant-induced OA, preventive measures should be implemented in the workplace to reduce future exposures and episodes.

For all causes of OA, the clinician should continue treating the asthma as appropriate, assist in the initiation of any appropriate compensation claim, and consider other workers at risk.

Определение

OA is asthma caused by the workplace and may result from immunologic or nonimmunologic stimuli.[1]

Sensitizer-induced OA is caused by immunologic stimuli and develops after a latency period between first exposure and the onset of symptoms.[2][3] Irritant-induced OA (including reactive airways dysfunction syndrome) is caused by nonimmunologic stimuli.[4]

Анамнез и осмотр

Ключевые диагностические факторы

occupational exposure to sensitizing agents or irritants
symptoms of asthma that improve during holidays
initial onset of asthma symptoms during a work period

Полная информация

Факторы риска

high-level exposure to sensitizer
atopy
genetic factors
smoking

Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

spirometry
chest x-ray
skin prick testing (SPT)
nonspecific bronchial hyper-responsiveness (NSBHR)
serial peak expiratory flow (PEF)

Полная информация

Исследования, проведение которых нужно рассмотреть

specific serum IgE assay
specific inhalation challenge (SIC)

Полная информация

Неотложные исследования

induced sputum cytology
fractional exhaled nitric oxide (FeNO)

Алгоритм лечения

Острый

sensitizer-induced

irritant-induced

ПРОДОЛЖЕНИЕ

symptomatic asthma

Составители

Авторы

Ryan Hoy, MB BS, MOEH, FRACP

Respiratory Physician

The Alfred Hospital

Melbourne

Victoria

Australia

Раскрытие информации

RH is an author of a reference cited in the topic.

Susan M. Tarlo, MB BS FRCP(C)

Professor of Medicine

University of Toronto

Respiratory Physician

Toronto Western Hospital

Toronto

Ontario

Canada

Раскрытие информации

SMT has received grant support from the Ontario Workplace Safety and Insurance Board (WSIB) and the Centre for Research Expertise in Occupational Disease (funded by Ontario Ministry of Labour). She has acted as a consultant for the Ontario Workplace Safety and Insurance Appeals Tribunal (WSIAT) and has provided clinical case assessments for WSIB. She has been a member of Task Forces for the European Academy of Allergy, Asthma and Clinical Immunology and an expert advisor to a committee of the European Respiratory Society. She is a member of the Occupational Disease Committee of the American Academy of Allergy, Asthma and Clinical Immunology (AAAAI). She has been an invited speaker at meetings of AAAAI and the American Thoracic Society. She is a coeditor of Current Opinion in Allergy and Clinical Immunology, and has received book royalties as coeditor of Asthma in the Workplace. SMT is an author of references cited in the topic.

Рецензенты

Ware Kuschner, MD

Associate Professor of Medicine

Stanford University

Stanford

Staff Physician

US Department of Veterans Affairs

Palo Alto Health Care System

Palo Alto

Раскрытие информации

WK declares that he has no competing interests.

Karin Pacheco, MD

Associate Professor of Medicine

National Jewish Medical Centre

Denver

Раскрытие информации

KP declares that she has no competing interests.

Philip Harber, MD

Professor of Medicine

University of California

Los Angeles

Раскрытие информации

PH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Barber CM, Cullinan P, Feary J, et al. British Thoracic Society clinical statement on occupational asthma. Thorax. 2022 May;77(5):433-42.Полный текст Аннотация

Tarlo SM, Balmes J, Balkissoon R, et al. Diagnosis and management of work-related asthma: American College Of Chest Physicians Consensus statement. Chest. 2008 Sep;134(3 suppl):1S-41S. Аннотация

Baur X, Sigsgaard T, Aasen TB, et al. Guidelines for the management of work-related asthma. Eur Respir J. 2012 Mar;39(3):529-45.Полный текст Аннотация

Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. May 2025 [internet publication].Полный текст

American College of Radiology. ACR appropriateness criteria: occupational lung diseases. 2019 [internet publication].Полный текст

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия
- Work-exacerbated asthma
- Occupational eosinophilic bronchitis
- Coincidental nonoccupational asthma
Больше Отличия
Рекомендации
- Global strategy for asthma management and prevention
- Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN)
Больше Рекомендации
Лифлеты для пациента
Asthma in adults
Больше Лифлеты для пациента
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Occupational asthma

Summary

Определение

Анамнез и осмотр

Ключевые диагностические факторы

Факторы риска

Диагностические исследования

Исследования, которые показаны в первую очередь

Исследования, проведение которых нужно рассмотреть

Неотложные исследования

Алгоритм лечения

sensitizer-induced

irritant-induced

symptomatic asthma

Составители

Авторы

Ryan Hoy, MB BS, MOEH, FRACP

Раскрытие информации

Susan M. Tarlo, MB BS FRCP(C)

Раскрытие информации

Рецензенты

Ware Kuschner, MD

Раскрытие информации

Karin Pacheco, MD

Раскрытие информации

Philip Harber, MD

Раскрытие информации

Peer reviewer acknowledgements

Disclosures

Список литературы

Основные статьи

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия

Рекомендации

Лифлеты для пациента

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Войдите в учетную запись, чтобы получить полноценный доступ к BMJ Best Practice